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Quaternary prevention: a summary

4 Jun

Quaternary prevention is the prevention of harms by medical interventions and as such a foundation block of medicine (primum non nocere). All services have adverse effects, all services might produce damage to health. A few services produce more benefits than harms in specific situations. Unnecessary and inappropriate services mainly produce harms, and few benefits if [...]

Clinical care and health disparities

10 Apr

In this review, we consider empirical studies from the United States and elsewhere, and we focus on how one aspect of health systems, clinical care, contributes to maintaining systematic differences in health across population groups characterized by social disadvantage. We consider inequities in clinical care and the policies that influence them. We develop a framework [...]

Influence vaccines: miracles, errors and business [updated 13/10/2011]

13 Oct

Influenza vaccines are useless. But every year millions of patients and healthy persons get vaccinated against flu virus. Cochrane reviews are consistent: flu vaccines are useless in healthy persons (elderly, adults and children under two years) and do not stop transmission in between humans. The case of Poland versus the world demonstrated that the vaccine [...]

Quaternary prevention: theory and practice

13 Oct

All health services have adverse effects, all health services might produce damage to health. A few services produce more benefits than harms in specific situations. Unnecessary and inappropriate services mainly produce harms, and few benefits if any. Quaternary prevention is the prevention of unnecessary and/or inappropriate services and the prevention of over-medicalisation. Quaternary prevention refers mainly to personal services, [...]

Flu vaccine 2011-2012, a terminator vaccine. More reason to say a reasonable “no” by professionals and patients

21 Sep

Year after year we have heard about the need of a new flu vaccine shot because the virus mutations. But this season, 2011-2012, the flu vaccine is exactly the same of the previous one, 2010-2011. Now the reason is that the immunity lasts one year. It is a “terminator” vaccine, as the sterile seeds you [...]

Critical steps in Europe to set up PHC under conditions of resource constraint. The case fo the Mediterranean countries

21 Sep

Primary health care have a different status across countries. This paper is an exploration of the reasons why. Much can be learned by analysing Spain as a benchmark, and comparing it with other Mediterranean countries (Greece, Italy, and Portugal). Critical steps in Europe to set up PHC under conditions of resource constraint. The case fo the [...]

PHC: western European best practices of institutional responsabilities

21 Sep

Primary health care provides services fitted to health needs of the population. To understand the way of working in PHC we need to consider a general framework with focus in the workforce (providers) and the way of payments (and incentives). Considerations around the Duth model helps in this paper to make proposals for improvement. PHC: [...]